Provider Demographics
NPI:1306930789
Name:LINDSEY, TOMMY G (DO)
Entity type:Individual
Prefix:
First Name:TOMMY
Middle Name:G
Last Name:LINDSEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9079
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-9079
Mailing Address - Country:US
Mailing Address - Phone:864-253-8080
Mailing Address - Fax:864-578-1045
Practice Address - Street 1:1071 BOILING SPRINGS RD
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-2201
Practice Address - Country:US
Practice Address - Phone:864-278-7088
Practice Address - Fax:864-278-7089
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2014-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMA-107297208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM000P4674Medicaid
NM000P4674Medicaid
345516901Medicare PIN